Mark Larson: Newsweek’s failure

Editor’s note: This commentary is by Mark Larson, commissioner of the Department of Vermont Health Access, the home of Vermont Health Connect. It was also submitted to Newsweek magazine.

I feel obligated to respond to the story “Doubling Down on Obamacare” by Lynnley Browning that was published on the website Newsweek. Despite providing Newsweek with a list of inaccuracies in the story, only two of which have been corrected, there are more inaccuracies with the story and the reporting that deserve a public response.

Where to begin is easy. It was clear from the first sentence of this article that a premium would be placed on sensationalism over actual reporting. “If Obamacare gets blown up by Congress later this year, you might want to thank (or blame, depending on your prejudices regarding the Affordable Care Act) the state of Vermont. If it can’t make it there, some argue, it can’t make it anywhere,” Ms. Browning wrote. Really? Despite the hyperbole, no single state, let alone one that represents only 0.5 percent of Congress and has actually been one of the more effective states at implementing Obamacare, will cause Congress to “blow up” the president’s single biggest domestic achievement.

The bigger issue here is that Ms. Browning built her story on the premise that the Affordable Care Act is not working in Vermont. The reality is actually quite different. Everyone knows the rollout out of Obamacare has been problematic, and Vermont has not been immune to the challenges. But despite those troubles, Vermont has consistently been one of the most effective states in signing up individuals. According to the non-profit Kaiser Family Foundation, Vermont has enrolled 33.4 percent of its eligible population through its Obamacare exchange. That’s a percentage nearly two times higher than almost every other state.

In addition, the central charge in Ms. Browning’s story, based on conversations with an anonymous source, is that CGI, the contractor building Vermont’s exchange, willfully mislead and pulled the wool over Vermont’s eyes. The allegation centers around one test on July 26, more than two months before the Oct. 1 launch date, that CGI told the state of Vermont was designed to show connectivity to the federal data hub and the ability to determine a hypothetical customer’s eligibility. The test did exactly that. Ms. Browning asked me about the test, and I answered her questions. However, she never asked me to respond to the key, anonymous allegation that the test was a fraud. Had she been forthright about her angle, I would have gladly provided her with documentation that showed Vermont’s exchange had passed a number of tests, both before and after the date in question, demonstrating the successful connection to the federal data hub.

… it’s the responsibility of journalists to take overtly politically motivated sources with a heavy dose of skepticism. Unfortunately, that didn’t happen with this story.

Ms. Browning also inaccurately reported why Vermont ended contract discussions with the company Oracle. She failed to report the real reason despite the fact I explained it to her. The decision to end discussions with Oracle was made because the company would not agree to the state’s legal terms. In retrospect, given the difficulties of rolling out exchanges in Vermont and around the country, it was absolutely the right call to insist on legal protections for the state of Vermont. But that didn’t make it into the story.

Lastly, it is clear from the substance of the story that Ms. Browning worked closely with two Republican opponents of Vermont’s Gov. Peter Shumlin in writing her story. Nearly every allegation in Ms. Browning’s story has already been raised by either Randy Brock, the 2012 Republican gubernatorial candidate, or his campaign manager Darcie Johnston. And this isn’t just conjecture. Brock told Vermont reporters in subsequent news reports that he helped Browning with the story, passing her materials, emails and public record requests. Johnston even described her influential role in getting the story published in a fundraising email to supporters of her anti-health care reform group.

It’s not that Johnston and Brock don’t deserve to have their voices heard. They do. But it’s the responsibility of journalists to take overtly politically motivated sources with a heavy dose of skepticism. Unfortunately, that didn’t happen with this story.

Like every state, Vermont worked hard before and after the launch of its federally mandated exchange program to ensure Vermonters are able to access coverage and qualify for federal subsidies. Like every state, our exchange program is vastly improved from where we started, and we continue to make the changes still needed to deliver the best program possible and fully acknowledge there is work to be done. What I do expect is fair and balanced reporting of our challenges, as well as our successes. I hope to see that in future Newsweek coverage of this critical issue.

Browning and Newsweek are guilty by engaging in the “sins of omissions” regarding her article and the subsequent hype in order to gain circulation among the less well informed. So much for truth and balanced reporting.

It seems you are more concerned with the public perception of the health exchange than the actual functionality of the exchange for Vermonters.

Also, I’m not sure why you are citing a third party non profit for your enrollment numbers when, as commissioner of health access, you should be able to provide those numbers yourself.

While you are waiting for Newsweek to publish a more positive article about your successes, Vermonters are still waiting on you to provide competent leadership in fixing Vermont Health Connect.

You might want to spend some less time writing commentary and spent that energy ensuring the contractors you hired are held accountable for their success and failures.

Vermonters still have to pay by check and mail those off to be processed by a company in Nebraska. Really?

If you felt as obligated to the people of Vermont to provide affordable health access as you do to replying to “inflammatory” news articles, we might just have a functioning health exchange and you wouldn’t have to be providing weekly updates of new security breaches to the legislature.

This is what you can expect from the national media as the for-profit health care industry rolls even more guns into Vermont. Darcie Johnston is sitting on a Rolodex of wingnut contributors who are more than eager to anonymously fund every effort to prevent Vermont from showing the rest America that sick people can be saved from suffering needlessly, losing their jobs because of illness and going bankrupt because of both of those causes.

Your critics would be credible if they offered a similar or better plan, but they don’t. They are apparently either shilling for the industry or dupes.

And by the way, your past leadership in the House to get Vermont this far along deserves its own chapter in the history of how Vermonters provided a health care model for the country. Keep up the good work!

Well put Chuck…also Randy Brock’s idea of health care reform is to turn the clock back to the days when health insurance companies could discriminate against older Vermonters, reject claims due to pre-existing conditions, and issue huge deductible junk policies that only gave the appearance of coverage.

Unfortunately, Newsweek and some others only want to regurgitate old news about the ACA roll out, complete with”anonymous” sources in the hopes on gaining on line readership, regardless of accuracy.

Chuck,
I think you should take Peters advice. Granted my article was incorrectly titled by the Herald, but the conclusion is the same.
The process needs to slow down until we know the cost details, who will pay, what will it pay for, and the risks/fall back position.
Even the Governor has stated on many occasions if this is not cost effective he will not proceed.
PS. your calculated cost estimate of $19.75/household/year is off by a factor of 1,000 times that number to reach the $5.92Billion

Thanks you for your clarification in response to an amazingly poorly researched article in Newsweek.

How much easier it would have been if Vermont had been granted a waiver to move straight to a publicly financed universal health care system. Instead we have to deal with the amazingly complex Rube Goldberg system that is the ACA until 2017.

The computer system will eventually work. The debate should center on the big unanswered questions: What will the new universal plan cover? What will it not cover? How much will the TRUE out of pocket costs be? What is the overall cost? How specifically will it be funded? Will it be better than Canada? Vermonters deserve answers today.

What the state needs now is a whistleblower to bring Vermonters some transparency to the VHC fiasco.
While the Shumlin administration is trying to keep the lid on the problems, including what we don’t know, the Governor is opposing the whistleblower law in the legislature. This OpEd is a reminder to any state employee who may know something that disclosure is not worth the risk.
I hope anyone reading this who has information has the courage to come forward.

Tim,
In the news today the VT US Atty is being asked to look into the Newsweek allegations based on a letter and evidence from a VHC insider/whistleblower. Is the US Atty is willing to look beyond politics and take this seriously for the benefit of Vermonters? We’ll see.

Now that Commissioner Larson has taken the time, energy and money to respond to the Newsweek article, maybe he can tell us why the state elected to attempt to build a Vermont health care exchange in the first place.

I ask this question since:

The construction of the VT exchange is costing tens of millions of hard earned tax payer dollars plus millions more in promotion and administration costs.

The federal exchange option was available to Vermont use at essentially no cost. Also, remember President Obama just told us the federal exchange is working fine.

VT has only two insurance companies to list policies on the exchange.

The real Shumlin plan is ditch Obamacare and go to a single payer system, ASAP.

So Commissioner Larson, if it was so important for you to respond to Newsweek, isn’t it time to tell Vermonters why the VT exchange was opted for in the first place.

Mr. Yankowski – you ask a question that many people feel confused about, but which has a straight-forward answer.
The answer is the state had to , by federal law, put the exchanges in place by the given date.
We tried to get waivers to start heading right towards first steps of the universal, publicly-funded health care laid out in Act 48. But although in theory the ACA welcome states innovating to find their own improvements on the ACA, as long as the resulting coverage was the same or better than what the ACA called for – the truth became different. The Republicans in Congress were so set on repealing the ACA that they had no patience with honoring the ACA by granting early waivers. Thus the forced wait until 2017 until the needed waivers are possible. Simple answer to your question : blame the Republicans !
And by golly, they’re all about trying to ruin things at the state level here in Vermont too. And they insist on doing it without offering any alternative vision for dealing with health care reform other than all the things that have already been tried for the last 50 years, and have landed us in the mess we’re in.
It’s time to finally move to the kind of health care systems that have worked better in all the rest of the world’s industrialized democracies, and been cheaper.

I don’t think the law required Vermont to create its own health care exchange. Vermont could have used the federal exchange and saved millions and millions of tax payer dollars as most other states did.

Trying to get waivers for Act 48 has nothing to do with creating the exchange.

I love your comment: “blame the Republicans”. Paula, there are hardly enough Republicans in this state to fill a parking space in Montpelier. You’ll have to find some else to blame.

I thought you were talking about the health exchange in general, and just not understanding the true desire to go to single payer system, or, more accurately, fulfill Act48, ASAP….
You make sound this like some sort of underhanded conspiracy, rather than the intention to carry out what was actually voted into law, and to try to do it without having to wait until 2017….and without having to set up the exchanges, which are so different from Act48, and a complication, rather than an enhancement of what Act48 calls for. So to more accurately answer your question : why the Vermont exchange instead of the federal exchange ? The answer was talked about plenty at the time : to try to tailor something that had nothing to do with the kind of reform laid out in Act48 into something which can ease the transition into what the reform is intended to do .

Now, about what you missed : the initial hope was that with waivers given early enough, the thought was we could have avoided the unnecessary & costly step of having to create exchanges. So of course they were connected. And the Republicans I was referring to were the CONGRESSIONAL Republicans, which reference you missed. Vermont Republicans were not the ones who could have done anything about it, no matter if they even did fill the parking lot.
However what our state Republicans can take credit for is not just being critical, which is useful in developing the best & most careful way forward…..no, rather than focusing on constructive criticism, they’ve gone for raising fear , confusion and misinformation. Worst of all they are content to try to undermine worthwhile efforts at real reform without offering any other game plan about providing health care for everyone while avoiding state bankruptcy.

Paula, The question that Peter Yankowski asked was pretty clear. As you said, the state had to set up the exchange by federal law. Vermont had two choices, use the federal exchange or set up our own. We spent over $83 million dollars to set up our own. If we used the federal exchange, we wouldn’t have spent $83 million of taxpayers money. That is a legitimate question and has nothing to do with anything you talked about in your comments. You need to focus on what Peter said, not what he didn’t say.

David – As I said, we each missed some of what the other was saying. I did speak to his question in my reply, and I agree- it was a perfectly legitimate question, and I had a good point to make in response to it.
He in turn criticized me for something I didn’t say, and I pointed that out too.

I really wish that the discussion and criticism would focus on just how BAD American health care is. You don’t have to dig very deep to find that some 45,000 Americans die each year due to the lack of health care. We Americans pay twice as much for health care, with worse health outcomes and have shorter life spans than other industrialized countries. Clearly, there’s room for improvement!

Those who are milking the system and driving up costs are those who have employer sponsored health care subsidized with employer tax breaks that otherwise would have gone into the U.S. Treasury. Those tax breaks are made up for by all of us having to pay more taxes. As a stockholder or a customer we are funding their employee health care when we buy their products/services or buy their stock. What really adds to our tax burden is that the entire immediate family of an employee is subsidized too. This isn’t fair to a single employee who doesn’t bring as large an economic burden to the workplace. Why aren’t those crying “Socialism” criticizing this socialistic practice?

So if we’re really serious about creating a level playing field when it comes to health care the American taxpayer should quit subsidizing employer sponsored health care is an artifact left over from World War II during a wage freeze when employers were allowed to offer benefits like health care to attract the best employees. World War II has been over for quite awhile now and there is no wage freeze. Why should we continue this unfair practice which drives up health care costs?

The time is long overdue to quit playing the blame game by attacking people like Mr. Larson who are making the effort to level the playing field and SAVE LIVES by fixing our dysfunctional non-system where in a worse case scenario when you get sick you lose your job, followed by losing your health insurance and finally your life.

Al, I don’t think your argument flies in VT. We have a high level of charity care in addition to several programs available for the poor and for the elderly. Of the 45,000 or so Vermonters who were the uninsured before ACA, many chose not to purchase health care even though they were offered coverage through employers or Catamount through the state, or sign up for Medicaid if they qualified. Can you identify a Vermonter who died due to lack of health care access? (Whether or not they availed themselves of it is another issue)

Post exchange, it’s a different world. Catamount is gone and some employers have dropped coverage. For employers and individual purchasers of insurance VHC has been a nightmare. As a result of the reform I believe three unfortunate outcomes will occur: more people will be on Medicaid, at high cost to the state, some who think they have coverage through VHC will not be enrolled correctly and lack coverage, and the number of uninsured will increase. All at a cost of nearly $100 million of taxpayer money. What a deal for the taxpayer…

I think Peter Yankowski is correct. VT should have defaulted to the federal exchange and skipped this whole debacle.

I and people I know well have experienced what are called “therapeutic misadventures” that hospitals are too embarrassed to report. They’re also worried about the legal ramifications. Bottom line, even if you are insured your chance of becoming a “therapeutic misadventure” in the good ole USA is higher than other industrialized countries.

These are almost always problems caused by the much praised PRIVATE sector that makes a regular habit of “over promising” and “under delivering” products and services to government officials like Mark Larson who make a good faith effort to give taxpayers the most bang for their buck. The public wrath and outrage should be rightfully directed at CGI, in this case, for failing to meet their contractual obligations! As with the DMV the solution to the CGI software should be to FIX the problems and move on rather than jeopardize lives by SHUTTING down the health exchange because of a few glitches.

When it comes to security breaches IBM, CCV, and Target among others have had hackers compromise my personal info. These security breaches were worse than the security breaches reported about vtconnect. Life, I am reminded, is not without some risks.

As a Veteran I’ve found that most of the outrageous mega cost over-runs and extreme late deliveries have historically been made by the Military Industrial Congressional complex that President Eisenhower warned the public about on leaving office. 60 Minutes recently did an expose on the F35 gargantuan cost over-runs and late deliveries. Not much outrage seems to be directed to shutting down this boondoggle. Google Senator Proxmire and Golden Fleece Award for more examples of wasteful spending.

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